Dermatitis Flashcards
Contact Dermatitis
Offending substance creates a reaction on the body
2 Types; Irritant Contact (ICD), localized and Allergic Contact (ACD), can be widespread
Non-pharm management: Cool, soapless showers, oatmeal baths, cool/moist compress 30 min, emollients after bathing
Astringents
Topical, OTC
IND: Dermatitis
MOA: Drying effect decreases oozing and relieves itching, decreases inflammation via blood vessel constriction
BOX: n/a
CON: n/a
ADR: n/a
Aluminum Acetate, Aluminum Sulfate/Calcium Acetate, Calamine Lotion, Witch Hazel. Lots of different ways to apply
Antihistamines
Oral over topical for ACD
Decrease itching
First generation is sedating, can be beneficial to help sleep. Diphenhydramine, Hydroxyzine, Cyproheptadine
Second generation, not so sedating except Cetirizine. Loratadine, Fexofenadine, Desloratadine, Levocetirizine
Atopic Dermatitis
Eczema
Chronic inflammatory
Moisturizers and topical corticosteroids; first line
Topical Immunosuppressants; second line. Pimecrolimus and Tacrolimus (calcineurin inhibitors)
PDE 4 Inhibitors; second line. Crisaborole
IL-4R antagonist: Dupilumab
Anti histamines
Pimecrolimus
Copy and paste
Tacrolimus
Copy and paste
Crisaborole
IND: Topical ointment for Atopic Dermatitis; 3 months or older (as opposed to the crolimuses)
MOA: PDE4 Inhibitor. Decreases inflammatory cytokine production
BOX: n/a
CON: n/a
ADR: n/a
Dupilumab
IND: Atopic Dermatitis; Older than 6 y/o
MOA: IgG4 monoclonal antibody; inhibits IL4 and IL13 to decrease cytokine inflammation
BOX: n/a
CON: n/a
ADR: Ab development; can be neutralizing, creates “resistance” to further treatment
Injection site reactions
Severe dermatologic and ophthalmic conditions
ROUTE: subQ can be done at home
Diaper Dermatitis Non-pharm Treatment
Keep dry and clean, change every 2 hours
Wash with lukewarm water and mild soap. Completely dry before new diaper
Consider changing diaper brand/wipes
Keep diapers loose and well ventilated
Consider napping on absorbent pad to promote drying and healing
Protectants
Diaper Dermatitis pharm treatment
Forms an occlusive barrier between skin and moisture from diaper
Zinc Oxide
White Petrolatum
Diaper Dermatitis Other Medications
Topical Corticosteroids: Infants are at high risk of excessive absorption and toxicity, limit to low potency, Hydrocortisone
Antifungals: Nystatin, clotrimazole, Micanazole to eradicate C. Albicans
ABX: Amoxicillin, Cephalexin are first line with high success rate if usual care/antifungals/steroids aren’t working
Magic Butt Cream
MC prescribed pharmacy compound
Combo of Zinc Oxide (protectant), Nystatin (antifungal), Maalox (astringent/antacid with cooling properties)
